For certain prescription drugs, Cigna-HealthSpring requires prior authorization. This means that you or your prescriber may request a coverage decision or exception for the prescribed medication. If you or your prescriber do not obtain approval, the drug may not be covered

Customer Forms

These forms are related to your Cigna-HealthSpring Medicare plan. As indicated below, some forms are available for online submission. To send a form via the web, simply click on the Online Form link and follow the instructions to enter the appropriate information.

Send this form to the same location where you are sending your grievance, coverage determination or appeal. if you are filing an appeal, grievance if you are filing a grievance, or initial determination or decision if you are requesting an initial determination or decision.

You or your appointed representative may request an appeal when you want to have us reconsider coverage of a medical item or service that you have already received and paid for after your initial request has been denied.

You can call, fax or write to us (see information to the right). You can find more information about the appeals process here.

You or your appointed representative may request an appeal when you want to have us reconsider coverage of a medical item or service that you have not yet received after it has been denied via the initial organization determination process.

You can call, fax or write to us (see information to the right). You can find more information about the appeals process here.

Permission To Discuss Limited Health Information With Family And Friends - Part D: English / en EspañolUse when you want to give permission to Cigna-HealthSpring to discuss limited information with family and friends.

Please Note: Forms marked with an asterisk (*) may NOT be used if you are in a group-sponsored plan. If you are in a group plan, please call the phone number on your Cigna ID card or contact your plan administrator if you have questions.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Arizona, Inc., Cigna HealthCare of St. Louis, Inc., HealthSpring Life & Health Insurance Company, Inc., HealthSpring of Florida, Inc., Bravo Health Mid-Atlantic, Inc., and Bravo Health Pennsylvania, Inc. The Cigna name, logos, and other Cigna marks are owned by Cigna Intellectual Property, Inc.

Cigna-HealthSpring is contracted with Medicare for PDP plans, HMO and PPO plans in select states, and with select State Medicaid programs. Enrollment in Cigna-HealthSpring depends on contract renewal.

Selecting these links will take you away from Cigna.com.

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